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Zhu T, Qiu X, Deng H, Feng H, Chen J, Huang Z, Li J, Liu S, Wang S, Gu Z, Wu Z, Yang Q, Liu G, Sechi LA, Caggiari G, You C, Fu G. Clinical analysis of 1301 children with hand and foot fractures and growth plate injuries. BMC Musculoskelet Disord 2024; 25:270. [PMID: 38589862 PMCID: PMC11000401 DOI: 10.1186/s12891-024-07407-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/02/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Fractures of hands and feet are common in children, but relevant epidemiological studies are currently lacking. We aim to study the epidemiological characteristics of hand and foot fractures and growth plate injuries in children and provide a theoretical basis for their prevention, diagnosis, and treatment. METHODS We retrospectively analyzed the data of children with hand and foot fractures who were hospitalized at Shenzhen Children's Hospital between July 2015 and December 2020. Data on demographic characteristics, fracture site, treatment method, etiology of injury, and accompanying injuries were collected. The children were divided into four age groups: infants, preschool children, school children, and adolescents. The fracture sites were classified as first-level (the first-fifth finger/toe, metacarpal, metatarsal, carpal, and tarsal) and second-level (the first-fifth: proximal phalanx, middle phalanx, distal phalanx, metacarpal, and metatarsal) sites. The changing trends in fracture locations and injury causes among children in each age group were analyzed. RESULTS Overall, 1301 children (1561 fractures; 835 boys and 466 girls) were included. The largest number of fractures occurred in preschool children (n = 549, 42.20%), with the distal phalanx of the third finger being the most common site (n = 73, 15.57%). The number of fractures in adolescents was the lowest (n = 158, 12.14%), and the most common fracture site was the proximal phalanx of the fifth finger (n = 45, 29.61%). Of the 1561 fractures, 1143 occurred in the hands and 418 in the feet. The most and least common first-level fracture sites among hand fractures were the fifth (n = 300, 26.25%) and first (n = 138, 12.07%) fingers, respectively. The most and least common first-level foot fracture locations were the first (n = 83, 19.86%) and fourth (n = 26, 6.22%) toes, respectively. The most common first-level and second level etiologies were life related injuries (n = 1128, 86.70%) and clipping injuries (n = 428, 32.90%), respectively. The incidence of sports injuries gradually increased with age, accounting for the highest proportion in adolescents (26.58%). Hand and foot fractures had many accompanying injuries, with the top three being nail bed injuries (570 cases, 36.52%), growth plate injuries (296 cases, 18.96%), and distal severed fracture (167 cases, 10.70%). Among the 296 growth plate injuries, 246 occurred on the hands and 50 on the feet. CONCLUSIONS In contrast to previous epidemiological studies on pediatric hand and foot fractures, we mapped the locations of these fractures, including proximal, shaft, distal, and epiphyseal plate injuries. We analyzed the changing trends in fracture sites and injury etiologies with age. Hand and foot fractures have many accompanying injuries that require attention during diagnosis and treatment. Doctors should formulate accident protection measures for children of different ages, strengthen safety education, and reduce the occurrence of accidental injuries.
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Affiliation(s)
- Tianfeng Zhu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Xin Qiu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Hansheng Deng
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
- Department of Biomedical Sciences, University of Sassari, 07100, Sassari, Italy
- Orthopaedic Department, Sassari University Hospital, 07100, Sassari, Italy
| | - Haoran Feng
- Shenzhen Pediatrics Institute of Shantou University Medical College, Shantou, People's Republic of China
| | - Jianlin Chen
- Shenzhen Pediatrics Institute of Shantou University Medical College, Shantou, People's Republic of China
| | - Zilong Huang
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Jiahui Li
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Shizhe Liu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Shuaiyin Wang
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Zhenkun Gu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Zhengyu Wu
- Clinical research center, Hefei cancer hospital, Chinese academy of sciences, Hefei, People's Republic of China
| | - Qisong Yang
- Hefei center for disease control and prevention, Hefei, People's Republic of China
| | - Gen Liu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | | | | | - Chao You
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China.
| | - Guibing Fu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China.
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Bakker AM, Albrecht M, Verkaik BJ, de Jonge RCJ, Buysse CMP, Blom NA, Rammeloo LAJ, Verhagen JMA, Riedijk MA, Yap SC, Tan HL, Kammeraad JAE. Sudden cardiac arrest in infants and children: proposal for a diagnostic workup to identify the etiology. An 18-year multicenter evaluation in the Netherlands. Eur J Pediatr 2024; 183:335-344. [PMID: 37889292 PMCID: PMC10858117 DOI: 10.1007/s00431-023-05301-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/17/2023] [Accepted: 10/21/2023] [Indexed: 10/28/2023]
Abstract
Sudden cardiac arrest (SCA) studies are often population-based, limited to sudden cardiac death, and excluding infants. To guide prevention opportunities, it is essential to be informed of pediatric SCA etiologies. Unfortunately, etiologies frequently remain unresolved. The objectives of this study were to determine paediatric SCA etiology, and to evaluate the extent of post-SCA investigations and to assess the performance of previous cardiac evaluation in detecting conditions predisposing to SCA. In a retrospective cohort (2002-2019), all children 0-18 years with out-of-hospital cardiac arrest (OHCA) referred to Erasmus MC Sophia Children's Hospital or the Amsterdam UMC (tertiary-care university hospitals), with cardiac or unresolved etiologies were eligible for inclusion. SCA etiologies, cardiac and family history and etiologic investigations in unresolved cases were assessed. The etiology of arrest could be determined in 52% of 172 cases. Predominant etiologies in children ≥ 1 year (n = 99) were primary arrhythmogenic disorders (34%), cardiomyopathies (22%) and unresolved (32%). Events in children < 1 year (n = 73) were largely unresolved (70%) or caused by cardiomyopathy (8%), congenital heart anomaly (8%) or myocarditis (7%). Of 83 children with unresolved etiology a family history was performed in 51%, an autopsy in 51% and genetic testing in 15%. Pre-existing cardiac conditions presumably causative for SCA were diagnosed in 9%, and remained unrecognized despite prior evaluation in 13%. CONCLUSION SCA etiology remained unresolved in 83 of 172 cases (48%) and essential diagnostic investigations were often not performed. Over one-fifth of SCA patients underwent prior cardiac evaluation, which did not lead to recognition of a cardiac condition predisposing to SCA in all of them. The diagnostic post-SCA approach should be improved and the proposed standardized pediatric post-SCA diagnostics protocol may ensure a consistent and systematic evaluation process increasing the diagnostic yield. WHAT IS KNOWN • Arrests in infants remain unresolved in most cases. In children > 1 year, predominant etiologies are primary arrhythmia disorders, cardiomyopathy and myocarditis. • Studies investigating sudden cardiac arrest are often limited to sudden cardiac death (SCD) in 1 to 40 year old persons, excluding infants and successfully resuscitated children. WHAT IS NEW • In patients with unresolved SCA events, the diagnostic work up was often incompletely performed. • Over one fifth of victims had prior cardiac evaluation before the arrest, with either a diagnosed cardiac condition (9%) or an unrecognized cardiac condition (13%).
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Affiliation(s)
- Ashley M Bakker
- Department of Pediatric Cardiology, Erasmus MC Sophia Children's Hospital, Postbus 2060, 3000 CB, Rotterdam, The Netherlands
| | - Marijn Albrecht
- Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Bas J Verkaik
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Rogier C J de Jonge
- Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Corinne M P Buysse
- Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Nico A Blom
- The Center for Congenital Heart Disease Amsterdam-Leiden, Amsterdam, The Netherlands
- Department of Pediatric Cardiology, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands
| | - Lukas A J Rammeloo
- The Center for Congenital Heart Disease Amsterdam-Leiden, Amsterdam, The Netherlands
- Department of Pediatric Cardiology, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands
| | - Judith M A Verhagen
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Maaike A Riedijk
- Department of Pediatric Intensive Care, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Sing C Yap
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Hanno L Tan
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Amsterdam, The Netherlands
- Netherlands Heart Institute, Utrecht, The Netherlands
| | - Janneke A E Kammeraad
- Department of Pediatric Cardiology, Erasmus MC Sophia Children's Hospital, Postbus 2060, 3000 CB, Rotterdam, The Netherlands.
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Bahall M, Legall G, Lalla C. Depression among patients with chronic kidney disease, associated factors, and predictors: a cross-sectional study. BMC Psychiatry 2023; 23:733. [PMID: 37817099 PMCID: PMC10566121 DOI: 10.1186/s12888-023-05249-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 10/03/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Depression with diverse etiologies is exacerbated by chronic diseases, such as chronic kidney disease (CKD), coronary artery disease (CAD), cancer, diabetes mellitus, and hypertension. This study aimed to analyse depression, its associations, and predictors among patients attending the kidney clinic of a teaching hospital. METHODS Data were collected from 01 August 2017 to 30 September 2017 via face-to-face interviews and examination of the medical records of a convenience sample of 314 patients. The patients were categorised broadly as stages I and II with an estimated glomerular filtration rate (eGFR) > 60 mls/min/1.73 m2, and with stages III, IV, and V or GFR ≤ 60 mls/ min/1.73 m2 (or CKD). The Patient Health Questionnaire (PHQ)-9 was the data collection instrument for depression-related data. RESULTS Participants were predominantly male (n = 179; 57.0%), aged over 60 years (n = 211; 67.2%), Indo-Trinbagonian (n = 237; 75.5%), and with stages III, IV, and V CKD. The two leading comorbid conditions were hypertension (83.4%) and diabetes mellitus (56.1%). Of the 261 (83.1%) patients with recorded eGFR, 113 (43.3%) had Stage III CKD. The mean depression (PHQ-9) score was 13.0/27 (±9.15), with 306 (97.5%) patients diagnosed as having depression with the following severities: mild (n = 116; 37.9%), moderate (n = 138, 45.1%), moderately severe (n = 38; 12.4%), and severe (n = 14; 4.6%). Depression was independent of sex. Nine sociodemographic variables were associated with depression; however, 'level of education', was the only predictor of depression with greater severity associated with lower levels of education. eGFR was negatively correlated with the PHQ-9 scores (Pearson's correlation, r = -0.144, p = 0.022). At least 78.3% of the patients who self-reported no depression had clinical depression (moderate, moderately severe, or severe) PHQ-9 scores ≥ 10. CONCLUSION Depression was a significant comorbidity among patients with CKD, with the majority displaying clinical depression. "Level of education" was the only predictor of depression. Self-reported depression is an unreliable method for evaluating clinical depression.
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Affiliation(s)
- Mandreker Bahall
- University of the West Indies, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad and Tobago.
| | - George Legall
- University of the West Indies, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad and Tobago
| | - Carlyle Lalla
- San Fernando General Hospital, Chancery Lane, San Fernando, Trinidad and Tobago
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Kpélao E, Ahanogbé KMH, Egu K, Doléagbénou AK, Moumouni AEK, Sossoukpe S, Ségbédji KK, Bakondé HE, Lawson D, Abaltou B, Abdoulaye HM, Békéti KA. Children hydrocephalus in Togo: etiologies, treatment, and outcomes. Surg Neurol Int 2022; 13:560. [PMID: 36600766 PMCID: PMC9805628 DOI: 10.25259/sni_927_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 11/16/2022] [Indexed: 12/05/2022] Open
Abstract
Background Hydrocephalus is frequent in sub-Saharan African countries. The postinfectious hydrocephalus tends to decrease. The objective of this study was to identify the etiologies and outcomes of hydrocephalus. Methods This was a retrospective study of hydrocephalus cases (0-15 years old) treated in the neurosurgery unit of the Sylvanus Olympio Hospital in Lomé over 10 years (2012-2021). At 1 year, the evolution distinguished in two categories: (1) Good psychomotor development: no delay in the acquisition of walking, language, and school. (2) Psychomotor delay: delay in the acquisition of walking, language, and school. Results We reported 305 children treated for hydrocephalus representing 1.8% of all neurosurgery unit patients and 34.2% of pediatric pathologies. There was a male predominance (60.6%). We noted second degree consanguinity in 8.5%. The positive maternal serologies were HIV (12.4%), syphilis (8.2%), and toxoplasmosis (2.6%). A malaria episode had been treated during the first trimester in 36.7% of the mothers. The main clinical sign of hydrocephalus was 91.5% of Macrocephalus. Congenital Malformafions were the most common etiologies of hydrocephalus (68.5%). Ventriculoperitoneal shunt was the main surgical method used and 16 deaths were recorded. The medium-term evolution (1 year) was evaluated in 36.1% and noted 61.8% of psychomotor retardation. Conclusion This study confirms the trend of the predominance of congenital causes of hydrocephalus in Africa, even if maternal infections can be involved in the development of some of them. The morbimortality of this pathology remains important, especially concerning neurocognitive outcomes.
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Affiliation(s)
- Essossinam Kpélao
- Corresponding author: Essossinam Kpélao, Neurosurgery Unit, CHU SO, Lomé, Togo.
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Dietrich E, Grimaux X, Martin L, Samimi M. Etiological diagnosis of macroglossia: Systematic review and diagnostic algorithm. Ann Dermatol Venereol 2022; 149:228-237. [PMID: 36229262 DOI: 10.1016/j.annder.2022.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/10/2021] [Accepted: 03/14/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The objective of this literature review was to list the different etiologies of macroglossia reported in the literature, to identify characteristics that might guide diagnosis, and to create a diagnostic algorithm. METHODS The bibliographic search was carried out between October 2019 and July 2020 in the PubMed research base using the keywords "macroglossia" (MESH) and/or "tongue enlargement". RESULTS Of the 1711 references identified, 615 articles were excluded, and 1096 abstracts were reviewed. We classified the different etiologies identified according to their mechanism and whether they were congenital or acquired. The etiologies are divided into the following categories: genetic malformation syndromes, non-syndromic congenital malformations, endocrinopathies, neuromuscular diseases, storage disorders, infectious, inflammatory, traumatic, and iatrogenic diseases. CONCLUSION Based on this review, we propose a diagnostic algorithm for macroglossia according to the characteristics described. The most common diagnoses among acquired causes were amyloidosis (13.7%), endocrinopathies (8.8%), myopathies (4%) and tongue tumors (6.7%). The most common congenital causes were aneuploidy, lymphatic malformations, and Beckwith-Wiedemann syndrome, which is the main cause of congenital macroglossia, even if it appears isolated.
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Affiliation(s)
- E Dietrich
- Dermatology Department, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, 49000 Angers, France.
| | - X Grimaux
- Dermatology Department, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, 49000 Angers, France
| | - L Martin
- Dermatology Department, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, 49000 Angers, France
| | - M Samimi
- Dermatology Department, Centre Hospitalier Universitaire de Tours, 2 boulevard Tonnellé, 37000 Tours, France
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Jafari E, Malekpour Afshar R, Aminzade R. Rates and Reasons of Laboratory Sample Rejection due to Pre-analytical Errors in Clinical Settings. Arch Iran Med 2022; 25:166-170. [PMID: 35429958 DOI: 10.34172/aim.2022.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 06/16/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Laboratory analysis errors in procedure or interpretation may be seen during the process of completing physician test orders. They may also result in rejection of the requests due to some applicability reasons. Hence, this study was carried out to determine the rate and reasons for such rejections in clinical settings. METHODS This cross-sectional comparative study was performed on 104008 laboratory tests in a one-year period in terms of the percentage and type of errors that occurred in Shahid Bahonar Hospital in Kerman, Iran, in 2018. The types of studied errors included hemolysis, sample clotting, insufficient sample size, and mistakes in labels or absence of labels on the sample. RESULTS In this study, 104008 laboratory tests were performed, with 2299 (2.21%) sample rejections, 456 (32.31%) complete blood count (CBC) sample clotting; 417 (29.38 %) hemolysis; and 150 (17.47 %) inadequate sample volume as the majority of errors. There was no statistically significant relationship between pre-analysis errors and clinical aspects (P=0.124). CONCLUSION According to the results, it may be concluded that considering the high prevalence of laboratory errors in comparison with the majority of other studies, continuous training courses and determination of the causes of these errors are crucial to attaining better function and basic knowledge.
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Affiliation(s)
- Elham Jafari
- Pathology and Stem Cells Research Center, Department of Pathology, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Malekpour Afshar
- Pathology and Stem Cells Research Center, Department of Pathology, Kerman University of Medical Sciences, Kerman, Iran
| | - Razieh Aminzade
- Pathology and Stem Cells Research Center, Department of Pathology, Kerman University of Medical Sciences, Kerman, Iran
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Munoz-Cerón J, Díaz-Forero F, Buitrago A, Chinchilla S. Secondary cluster headache and numb chin syndrome as initial manifestation of high-grade B-lymphoma: a case report. J Med Case Rep 2021; 15:468. [PMID: 34517893 PMCID: PMC8439040 DOI: 10.1186/s13256-021-03016-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 07/19/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cluster headache is a primary condition characterized by severe headache accompanied by trigeminal autonomic signs. By definition, it is not attributed to underlying etiologies; however, under certain clinical characteristics, secondary etiologies must be ruled out. CASE PRESENTATION We present the case of a 48-year-old Hispanic man with a history of episodic right orbital pain, lasting 30 minutes, associated with ipsilateral tearing, who prior to the onset of his symptoms reported loss of appetite, weight loss, and paresthesias in the right chin region. After work-up studies, high-grade lymphoma with infiltration to the right submental nerve was diagnosed, in which numb chin syndrome was the initial presentation. Despite initiation of treatment, the patient died 3 weeks after the diagnosis. CONCLUSIONS In the study of cluster headache, underlying etiologies must be considered when there are atypical clinical manifestations. Within these etiologies, metastases to pericranial nerves must be included, which, besides generating localized symptoms, can activate the trigeminal vascular system simulating headaches of primary etiology.
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Affiliation(s)
- Joe Munoz-Cerón
- Departamento de Neurologia, Hospital Univesitario Mayor MEDERI - Universidad del Rosario, Bogotá, Colombia.
- Departamento de Neurologia , Clinica Univesitaria Colombia - Keralty, Bogotá, Colombia.
| | - Felipe Díaz-Forero
- Departamento de Neurologia, Hospital Univesitario Mayor MEDERI - Universidad del Rosario, Bogotá, Colombia
| | - Adriana Buitrago
- Deparatmento de Medicinia Nuclear - Hospital Univesitario Mayor MEDERI, Universidad del Rosario, Bogotá, Colombia
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Beuvon C, Martin M, Baillou C, Roblot P, Puyade M. Etiologies of Polyclonal Hypergammaglobulinemia: A scoping review. Eur J Intern Med 2021; 90:119-121. [PMID: 34127335 DOI: 10.1016/j.ejim.2021.05.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Clément Beuvon
- Service de Médecine Interne, Maladies infectieuses et Tropicales, Centre Hospitalier Universitaire (CHU) de Poitiers, 2, rue de la Milétrie, 86021 Poitiers cedex, France; Université de Poitiers, 6, rue de la Milétrie, TSA 51115, 86073 Poitiers cedex 9, France.
| | - Mickaël Martin
- Service de Médecine Interne, Maladies infectieuses et Tropicales, Centre Hospitalier Universitaire (CHU) de Poitiers, 2, rue de la Milétrie, 86021 Poitiers cedex, France; Université de Poitiers, 6, rue de la Milétrie, TSA 51115, 86073 Poitiers cedex 9, France
| | - Chloé Baillou
- Service de Médecine Interne, Maladies infectieuses et Tropicales, Centre Hospitalier Universitaire (CHU) de Poitiers, 2, rue de la Milétrie, 86021 Poitiers cedex, France
| | - Pascal Roblot
- Service de Médecine Interne, Maladies infectieuses et Tropicales, Centre Hospitalier Universitaire (CHU) de Poitiers, 2, rue de la Milétrie, 86021 Poitiers cedex, France; Université de Poitiers, 6, rue de la Milétrie, TSA 51115, 86073 Poitiers cedex 9, France
| | - Mathieu Puyade
- Service de Médecine Interne, Maladies infectieuses et Tropicales, Centre Hospitalier Universitaire (CHU) de Poitiers, 2, rue de la Milétrie, 86021 Poitiers cedex, France
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Chen AP, Chuang C, Huang YC, Wu PF, Huang SF, Cheng NC, Lin YT, Chen SJ, Huang LJ, Lee CL, Chen HP, Chan YJ, Wang FD. The epidemiology and etiologies of respiratory tract infection in Northern Taiwan during the early phase of coronavirus disease 2019 (COVID-19) outbreak. J Microbiol Immunol Infect 2021:S1684-1182(21)00102-X. [PMID: 34217634 DOI: 10.1016/j.jmii.2021.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 03/02/2021] [Accepted: 05/13/2021] [Indexed: 12/16/2022]
Abstract
Background Coronavirus disease 2019 (COVID-19) manifests symptoms as common etiologies of respiratory tract infections (RTIs). During the pandemic of COVID-19, identifying the etiologies correctly from patients with RTI symptoms was crucial in not only disease control but preventing healthcare system from collapsing. By applying sensitive PCR-based molecular assays, we detected the etiologic agents and delineated the epidemiologic picture of RTIs in the early phase of COVID-19 pandemic. Methods From December 2019 to February 2020, we screened patients presented with RTIs using multiplex PCR-based diagnostic assays. Data from pediatric and adult patients were compared with different months and units in the hospital. Results Of all 1631 patients including 1445 adult and 186 pediatric patients screened, 8 viruses and 4 bacteria were identified. Positive rates were 25% in December, 37% in January, and 20% in February, with pediatric patients having higher positive rates than adults (Ps < 0.001). In pediatric patients, RhV/EnV was the most commonly detected, followed by parainfluenza viruses. Most Mycoplasma pneumoniae infection occurred in pediatric patients. RhV/EnV was the most commonly detected agent in pediatric patients admitted to intensive care units (ICUs), while influenza accounted for the majority of adult cases with critical illness. Noticeably, seasonal coronavirus ranked second in both adult and pediatric patients with ICU admission. Conclusion While we focused on the pandemic of COVID-19, common etiologies still accounted for the majority of RTIs and lead to severe diseases, including other seasonal coronaviruses.
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Lekskul A, Wuthisiri W, Tangtammaruk P. The etiologies of isolated fourth cranial nerve palsy: a 10-year review of 158 cases. Int Ophthalmol 2021; 41:3437-3442. [PMID: 34014458 DOI: 10.1007/s10792-021-01907-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To identify the etiologies of isolated fourth cranial nerve palsy in Ramathibodi hospital, Thailand. METHODS Patients diagnosed with isolated fourth nerve palsy from January 1, 2009, through July 31, 2020 in Ramathibodi Hospital, were included in this retrospective, observational case series. The demographic data of patients, age at presentation, the etiologies of isolated fourth nerve palsy and neuroimaging results (if indicated) were recorded. RESULTS We identified 154 unilateral and 4 bilateral cases of isolated fourth nerve palsy. Mean age at presentation was 38.89 ± 25.71 years old. Most of the unilateral cases were congenital (57.79%), with microvasculopathy (27.92%), intracranial neoplasm (8.44%) and other etiologies. Trauma with closed head injury was the most common etiology of bilateral cases (75%), followed by ruptured arteriovenous malformation (25%). Twenty-one of the 43 (48.84%) patients with microvasculopathy fourth nerve palsy underwent neuroimaging, with normal findings, and all patients' symptoms resolved within 6 months of symptom onset. CONCLUSIONS In our series, most of the isolated fourth nerve palsy cases were congenital, followed in frequency by microvasculopathy and intracranial tumor, as in many studies. In cases of microvasculopathy, the clinical signs and symptoms resolved within 6 months in all cases: observation was sufficient, with no necessity for neuroimaging. However, neuroimaging should be considered in cases with atypical presentations, such as headache, periorbital pain, or if there is rapid progression or no recovery.
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Affiliation(s)
- A Lekskul
- Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - W Wuthisiri
- Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - P Tangtammaruk
- Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
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Gao F, Wang J, Chen J, Wang X, Chen Y, Sun X. Etiologies and clinical characteristics of young patients with angle-closure glaucoma: a 15-year single-center retrospective study. Graefes Arch Clin Exp Ophthalmol 2021; 259:2379-2387. [PMID: 33876278 PMCID: PMC8352827 DOI: 10.1007/s00417-021-05172-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/12/2021] [Accepted: 03/22/2021] [Indexed: 11/07/2022] Open
Abstract
Purpose To investigate the etiologies and the clinical characteristics of angle-closure glaucoma (ACG) patients younger than 40 years old in Chinese. Methods Inpatients with diagnosis of ACG and diagnosed age younger than or equal to 40 years old, who were admitted in Eye, Ear, Nose, and Throat Hospital Fudan University from 2002 to 2017, were included in this retrospective non-comparative case series. The underlying causes and clinical features for all the patients were analyzed by comprehensive review of medical charts. Results A total of 298 patients (463 eyes) met the criteria, including 153 females (51.3%) and 145 males (48.7%); the mean age was 25.6 ± 13.0 years. Primary angle-closure glaucoma (PACG), uveitis, and anterior segment dysgenesis (ASD) were the top three etiologies in our patients, which accounted for 32.6%, 20.3%, and 15.1% of the total patients respectively. PACG mainly occurs after 30 years of age and ASD is the top reason of ACG in patients younger than 20 years old. Other known etiologies include iridocorneal endothelial syndrome, neovascular glaucoma, nanophthalmos, retinitis pigmentosa, spherophakia, bestrophinopathy, persistent fetal vasculature, iridociliary cysts, congenital retinoschisis, Marfan’s syndrome, retinopathy of prematurity, familial exudative vitreoretinopathy, congenital retinal folds, Coat’s disease, and neurofibromatosis. Conclusions We described the uncommon presentation of ACG in Chinese young patients. Although unusual, most of the etiologies could be identified. Therefore, more careful and comprehensive examinations are needed for early detection and timely treatment for young ACG patients.![]() Supplementary Information The online version contains supplementary material available at 10.1007/s00417-021-05172-6.
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Affiliation(s)
- Feng Gao
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Jiajian Wang
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Junyi Chen
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Xiaolei Wang
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Yuhong Chen
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China. .,NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China.
| | - Xinghuai Sun
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China. .,NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China. .,State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China.
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Alamou S, Agbahoungba L, Longue L, Abouki COA, Aigbe N, Odoulami L, Sounouvou I, Tchabi S. [Tomographic appearance and etiologies of epimacular membranes in Cotonou]. J Fr Ophtalmol 2021; 44:519-22. [PMID: 33612325 DOI: 10.1016/j.jfo.2020.06.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 05/30/2020] [Accepted: 06/05/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE To study the tomographic appearance and etiologies of epimacular membranes in Cotonou. PATIENTS, MATERIALS AND METHODS This was a descriptive, analytical study with retrospective data collection. It took place at the Cotonou Retinal Testing Center and included all patients who underwent macular OCT testing between January 1, 2016 and June 30, 2018. RESULTS Of the 604 subjects examined, 32 patients (5.3%) exhibited an epimacular membrane. Epimacular membrane in combination with posterior vitreous detachment and contraction accounted for 44.74% of cases. 42.31% of the fellow eyes had developed a posterior vitreous detachment. The majority of the membranes were idiopathic. Proliferative diabetic retinopathy and posterior uveitis were the main risk factors for secondary membranes. CONCLUSION Epimacular membrane is a potentially blinding condition. The risk of bilateral involvement is significant, and patient access to OCT remains a concern in developing countries.
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Paul J. Colonoscopic Finding of Patients with Lower Gastrointestinal Bleeding at Different Age Group in Eastern Part of India - An Observational Study. Prague Med Rep 2020; 121:25-34. [PMID: 32191617 DOI: 10.14712/23362936.2020.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Incidence of lower gastrointestinal (GI) bleeding (LGIB) is increasing over time. It can be seen in all age group patients, commonly associated with pre-existing comorbidities and is one of the common indications of colonoscopy. This study was done to identify common causes of LGIB in eastern part of India, because there is no previous study from Eastern India to identify the common causes of lower GI bleeding diagnosed by colonoscopy in different age group patients. Consecutive 64 patients with LGIB were included in this study from June 2018 to March 2019. We divided our study population into three groups, such as group A (20 years to 40 years), group B (41 years to 60 years), and group C (more than 60 years). Data were entered into Excel and then transferred into SPSS version 22 for statistical analysis. Mean age of study population was 49.83 ± 19.06 years. Normal colonoscopic finding was seen in 7 patients (10.9%). Most common colonoscopic findings of our study population were hemorrhoids (n=32; 50%), anal fissure (n=11; 17.2%) and isolated rectal ulcer (n=9; 14.1%). Colorectal growth was seen in 6 patients (9.4%), among them female patients were more commonly affected than male patients. Therefore, most common causes of LGIB in eastern part of India are hemorrhoids, anal fissure and isolated rectal ulcer. Male individuals are more commonly affected by LGIB.
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Affiliation(s)
- Jayanta Paul
- Department of Gastroenterology, Desun Hospital and Heart Institute, Kolkata, India.
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Zhao H, Dai Y, Zhou YH. Overview of infection causing hepatitis other than non-A to E hepatitis virus during pregnancy. Best Pract Res Clin Obstet Gynaecol 2020; 68:89-102. [PMID: 32247771 DOI: 10.1016/j.bpobgyn.2020.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 12/20/2022]
Abstract
Abnormal liver function tests during pregnancy are common. While hepatic injury during pregnancy mostly has minimal adverse influence on maternal and fetal outcomes, severe maternal and fetal morbidities, and even death, sometimes occur. Here, we review the epidemiology, clinical features, diagnosis, and management of hepatitis during pregnancy caused by the less common pathogens, including Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex viruses (HSVs), dengue fever, malaria, leptospirosis, Q fever, typhoid fever, and other occasional infections, as well as the implications on breastfeeding of the infants. Hepatitis during pregnancy with fever and systemic clinical presentations, which are not attributable to the common infectious agents, should raise the suspicion of infection with above-mentioned pathogens, and appropriate laboratory tests are required. Early recognition of severe hepatitis or acute liver failure is critical in initiating appropriate and specific therapy, together with systemic supportive care, to reduce maternal and fetal mortality and long-term sequelae.
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Affiliation(s)
- Hong Zhao
- Department of Infectious Diseases, Nanjing Second Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yimin Dai
- Department of Obstetrics & Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Yi-Hua Zhou
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
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15
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Ram P, Shah M, Lo KBU, Agarwal M, Patel B, Tripathi B, Arora S, Patel N, Jorde UP, Banerji S. Etiologies and predictors of readmission among obese and morbidly obese patients admitted with heart failure. Heart Fail Rev 2020; 26:829-838. [PMID: 32002731 DOI: 10.1007/s10741-020-09920-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The relationship between severity of obesity and outcomes in heart failure (HF) has long been under debate. We studied index HF admissions from the 2013-14 National Readmission Database. Admissions were separated into three weight-based categories: non-obese (Non-Ob), obese (Ob), and morbidly obese (Morbid-Ob) to analyze hospital mortality and readmission at 30 days and 6 months. We investigated etiologies and predictors of 30-day readmission among these weight categories. We studied a total of 578,213 patients of whom 3.0% died during index hospitalization (Non-Ob 3.3% vs. Ob 1.9% vs. Morbid-Ob 1.9%; p < 0.01). Non-Ob comprised 79.5%, Ob 9.9%, and Morbid-Ob 10.6% of patients. Morbid-Ob patients were the youngest among age categories and more likely to be female. In-hospital mortality during readmission at 30 days and 6 months was significantly lower among Morbid-Ob and Ob compared with Non-Ob patients (all p < 0.01). Thirty-day readmission among Morbid-Ob was lower than Non-Ob and higher than Ob patients (19.6% vs. 20.5% vs. 18.6%, respectively; p < 0.01). Morbid-Ob patients were less likely to be readmitted for cardiovascular etiologies compared with both Ob and Non-Ob (45.0% vs. 50.3% vs. 50.6%; p < 0.01). Multivariable regression analysis revealed that Ob (adjusted odds ratio 0.84, 95% confidence intervals 0.82-0.86) and Morbid-Ob (aOR 0.83, 95% CI 0.81-0.85) were independently associated with lower 30-day readmission. Readmission at 6 months was highest among Morbid-Ob followed by Non-Ob and Ob (51.1% vs. 50.2% vs. 49.1%, p < 0.01). Morbid-Ob and Ob patients experience lower in-hospital mortality during index HF admission and during readmission with 30 days or 6 months compared with Non-Ob. Morbid-Ob patients experience greater readmission at 6 months despite the lower rate at 30 days post discharge. Morbid-Ob patients are most likely to be readmitted for non-cardiovascular causes.
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Affiliation(s)
- Pradhum Ram
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA, 19141, USA.
| | - Mahek Shah
- Department of Cardiology, Montefiore Medical Center, Bronx, NY, USA
| | - Kevin Bryan U Lo
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA, 19141, USA
| | - Manyoo Agarwal
- Department of Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Brijesh Patel
- Department of Cardiology, Henry Ford Health System, Jackson, MI, USA
| | - Byomesh Tripathi
- Department of Cardiology, Geisinger Medical Center, Danville, PA, USA
| | - Shilpkumar Arora
- Department of Medicine, Guthrie Robert Packer Hospital, Sayre, PA, USA
| | - Nilay Patel
- Department of Cardiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ulrich P Jorde
- Department of Cardiology, Montefiore Medical Center, Bronx, NY, USA
| | - Sourin Banerji
- Department of Cardiology, Christiana Care Health, Newark, DE, USA
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Mekonnen GK, Mengistie B, Sahilu G, Kloos H, Mulat W. Etiologies of diarrhea and drug susceptibility patterns of bacterial isolates among under-five year children in refugee camps in Gambella Region, Ethiopia: a case control study. BMC Infect Dis 2019; 19:1008. [PMID: 31779589 PMCID: PMC6883563 DOI: 10.1186/s12879-019-4599-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 10/28/2019] [Indexed: 01/20/2023] Open
Abstract
Background Despite substantial global effort and updated clinical management guidelines, diarrhea continues to be among leading worldwide causes of morbidity and mortality in children. Infectious diarrhea, the most common form of diarrhea causes substantial morbidity and mortality among children in developing countries, and the muddled use of antibiotics needs caution due to potential problems of drug-resistance. The aim of this study is to identify etiologies of diarrhea and drug susceptibility patterns of bacterial isolates in under-five children in refugee camps in Gambella Region, Ethiopia. Methods An institution- based matched case control study was conducted using a questionnaire-based interview from June to December 2017 in Pugnido and Teirkidi refugee camps. Stool samples were collected and parasites causing diarrhea were identified by wet mount microscopy. Conventional culture supplemented with API 20E identification kit was used to identify Salmonella and Shigella species. Antibiotic susceptibility of bacterial isolates was investigated by using the disk diffusion method. The association between etiologies and diarrhea was analyzed using McNemar test or Fisher exact test with 95% confidence interval at a level of significance of P < 0.05. Results The overall prevalence of enteric pathogens were 55 (41.0%) in diarrhea cases and 18 (13.4%) in healthy controls. The detected etiologies include Giardia lambia (28), Shigella spp. (16), E. hystolyotica/dispar (13), Ascaris lumbricoides (10), Salmonella spp. (6), Cryptosporidium parvum (6), Hymenolepis nana (4) and Isospora belli (3). All isolates were sensitive to kanamycine and ceftazidime. The high resistance rate was observed against ampicillin (100%), amoxicillin (100%), erythromycin (52%), chloramphenicol (47.5%), tetracycline (40.5%), cotrimoxazole (34.8%) and amoxicillin-clavulanic acid (33%). The majorities of the isolates had a low rate of resistance to ciprofloxacin (8.7%), naldxic acid (8.7%) and amikacin (13%). Conclusions Giardia lamblia, E. Hystolytica/dispar, and Shigella spp are the common etiologies of diarrhea in children in the studied refugee camps. The study also showed that significant numbers of bacterial isolates were resistant to the commonly used antimicrobial drugs. Therefore, improving clinical laboratory services and promoting evidence-based drug prescription may reinforce proper use of antibiotics and reduce the emergence of microbial resistance.
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Affiliation(s)
- Getachew Kabew Mekonnen
- Addis Ababa University, Ethiopian Institute of Water Resources, PO. BOX 150461, Addis Ababa, Ethiopia. .,Addis Ababa City Administration, PO. Box 8470, Addis Ababa, Ethiopia. .,Haramaya University, College of Health and Medical Sciences, PO. Box 1570, Harar, Ethiopia.
| | - Bezatu Mengistie
- Haramaya University, College of Health and Medical Sciences, PO. Box 1570, Harar, Ethiopia
| | - Geremew Sahilu
- Addis Ababa University, Ethiopian Institute of Water Resources, PO. BOX 150461, Addis Ababa, Ethiopia
| | - Helmut Kloos
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Worku Mulat
- Wello University, College of Medicine and Health Sciences, Desse, Ethiopia
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Abstract
Precocious puberty (PP) in girls refers to secondary sexual development occurring earlier than the lower end of normal for the onset of puberty. It might be the presenting feature of a serious underlying condition or signify a common variation of normal for which no treatment is necessary. Depending on the source and type of sex steroids involved, clinical findings may indicate exposure to estrogens, androgens, or both. Likewise, the onset of the PP might be gradual or abrupt and the rate of progression is variable. Recent years have witnessed exciting advancements in the understanding of the molecular genetic basis for some forms of PP in girls as well as in the development of additional treatment options. In this review an update on the most commonly encountered causes of PP in girls including their clinical presentation, pathophysiology, diagnosis, and management are provided. Recommendations regarding when to refer, and areas in particular need of additional research are also delineated.
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Affiliation(s)
- Erica A Eugster
- Division of Endocrinology, Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana.
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18
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Rovesti G, Orsi G, Kalliopi A, Vivaldi C, Marisi G, Faloppi L, Foschi FG, Silvestris N, Pecora I, Aprile G, Molinaro E, Riggi L, Ulivi P, Canale M, Cucchetti A, Tamburini E, Ercolani G, Fornaro L, Andreone P, Zavattari P, Scartozzi M, Cascinu S, Casadei-Gardini A. Impact of Baseline Characteristics on the Overall Survival of HCC Patients Treated with Sorafenib: Ten Years of Experience. Gastrointest Tumors 2019; 6:92-107. [PMID: 31768353 DOI: 10.1159/000502714] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 07/29/2019] [Indexed: 12/24/2022] Open
Abstract
Background Sorafenib has been established as the standard of care for patients with advanced hepatocellular carcinoma (HCC) since 2007 on the basis of two landmark trials (SHARP and Asia-Pacific). Ten years have passed since then and, despite much research in the field, still no validated real-life prognostic markers are available for HCC patients treated with this drug. Therefore, going through 10 years of research into sorafenib of several Italian Cancer Centers, we conducted a field-practice study aimed at identifying baseline clinical factors that could be significantly associated with overall survival (OS). Method Univariate/multivariate analyses were conducted to retrospectively identify the impact of baseline characteristics on the OS of 398 advanced HCC patients treated with sorafenib. Results Based on univariate analysis, α-fetoprotein (AFP), albumin, AST, bilirubin, Child-Pugh, ECOG, systemic immune-inflammation index (SII), albumin-bilirubin (ALBI) grade, and portal vein thrombosis were significantly associated with shorter OS. Following adjustment for clinical covariates positive in univariate analysis, the multivariate analysis including AFP, age, etiology, albumin, aspartate transaminase (AST), bilirubin, Child-Pugh, LDH, platelet-to-lymphocyte ratio, ECOG, ALBI grade, portal vein thrombosis, SII, and BCLC stage identified increase in LDH, age >70 years, no viral etiologies, ECOG >0, albumin <35, ALBI grade 2, and AST >40 as prognostic factors for poorer OS based on the 5% significance level. Conclusion Our study highlights that baseline hepatic function, patient-centered variables, and etiology have prognostic value. These findings might have implications in terms of therapeutic decision-making and patient counseling.
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Affiliation(s)
- Giulia Rovesti
- Division of Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Giulia Orsi
- Division of Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Andrikou Kalliopi
- Division of Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Caterina Vivaldi
- Department of Medical Oncology, Pisa University Hospital, Pisa, Italy
| | - Giorgia Marisi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Luca Faloppi
- Oncology Unit, Macerata Hospital, Macerata, Italy
| | | | | | - Irene Pecora
- Department of Medical Oncology, Pisa University Hospital, Pisa, Italy
| | | | - Eleonora Molinaro
- Division of Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Laura Riggi
- Division of Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Paola Ulivi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Matteo Canale
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Alessandro Cucchetti
- Department of Medical and Surgical Sciences-DIMEC, S. Orsola-Malpighi Hospital, Alma Mater Studiorum-University of Bologna, Bologna, Italy.,General Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy
| | | | - Giorgio Ercolani
- Medical Oncology Unit, Hospital of Vicenza, Vicenza, Italy.,Department of Medical and Surgical Sciences-DIMEC, S. Orsola-Malpighi Hospital, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Lorenzo Fornaro
- Department of Medical Oncology, Pisa University Hospital, Pisa, Italy
| | - Pietro Andreone
- Division of Internal and Metabolic Medicine, Baggiovara Hospital, University of Modena and Reggio Emilia, Modena, Italy
| | - Patrizia Zavattari
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Mario Scartozzi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefano Cascinu
- Department of Medical Oncology, Università Vita-Salute, San Raffaele Hospital IRCCS, Milan, Italy
| | - Andrea Casadei-Gardini
- Division of Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
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Mamadou Z, Tanoh C, Doumbia M, Toudou MD, Amon-Tanoh M, Yapo-Ehounoud C, Aka-Anghui Diarra E. [Epidemiological and Etiological Characteristics of Myelopathies in the Neurology Department of the University Hospital Center of Cocody, Abidjan (Ivory Coast)]. ACTA ACUST UNITED AC 2019; 111:201-204. [PMID: 30794353 DOI: 10.3166/bspe-2018-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 09/17/2018] [Indexed: 11/20/2022]
Abstract
The term myelopathy defines a suffering of the spinal cord whatever the etiologies. They often represent real therapeutic emergencies and are burdened by serious functional sequelae. The aim of this work was to describe the epidemiological, clinical, and etiological aspects of all myelopathies. We have conducted a prospective and descriptive study from January 1, 2015 to December 31, 2016 at the Neurology department of the Cocody University Hospital in Abidjan. Seventy-one patients out of 1,006 were included, that is, a prevalence of 7.06%. The sex ratio was 1.7. The average age was 49 years old. HIV was associated with myelopathy in 24.7% of cases. Medullary compression syndrome was predominant. Pott's disease was the etiology of compressive myelopathies (43.9%) followed by bone metastases (26.8%). Tuberculous myelitis was the most common etiology of non-compressive myelopathies (30%). Myelites of undetermined causes account for 50% of non-compressive myelopathies.
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Affiliation(s)
- Z Mamadou
- Service de neurologie, CHU de Cocody, BP V 13 Abidjan, Côte-d'Ivoire
| | - C Tanoh
- Service de neurologie, CHU de Cocody, BP V 13 Abidjan, Côte-d'Ivoire
| | - M Doumbia
- Service de Neurologie, CHU de Yopougon, Côte d'Ivoire
| | - M D Toudou
- Service de médecine interne et spécialités médicales, Hôpital national de Niamey, Niger
| | - M Amon-Tanoh
- Service de neurologie, CHU de Cocody, BP V 13 Abidjan, Côte-d'Ivoire
| | - C Yapo-Ehounoud
- Service de neurologie, CHU de Cocody, BP V 13 Abidjan, Côte-d'Ivoire
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Abstract
Hypoparathyroidism is characterized by hypocalcemia and hyperphosphatemia and is due to insufficient levels of circulating parathyroid hormone. Hypoparathyroidism may be an isolated condition or a component of a complex syndrome. Although genetic disorders are not the most common cause of hypoparathyroidism, molecular analyses have identified a growing number of genes that when defective result in impaired formation of the parathyroid glands, disordered synthesis or secretion of parathyroid hormone, or postnatal destruction of the parathyroid glands.
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Affiliation(s)
- Rebecca J Gordon
- Division of Endocrinology and Diabetes, The Center for Bone Health, The Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, 11 Northwest Tower, Suite 30, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
| | - Michael A Levine
- Division of Endocrinology and Diabetes, The Center for Bone Health, The Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, 3615 Civic Center Boulevard, Abramson Research Building, Room 510A, Philadelphia, PA 19104, USA
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21
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Shah M, Ram P, Lo KBU, Sirinvaravong N, Patel B, Tripathi B, Patil S, Figueredo VM. Etiologies, predictors, and economic impact of readmission within 1 month among patients with takotsubo cardiomyopathy. Clin Cardiol 2018; 41:916-923. [PMID: 29726021 DOI: 10.1002/clc.22974] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/26/2018] [Accepted: 04/29/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Limited data exist on readmission among patients with takotsubo cardiomyopathy (TC), a commonly reversible cause of heart failure. HYPOTHESIS We sought to identify etiologies and predictors for readmission among TC patients. METHODS We queried the National Readmissions Database for 2013-2014 to identify patients with primary admission for TC using ICD-9-CM code 429.83. Patients readmitted to hospital within 1 month after discharge were further evaluated to identify etiologies, predictors, and resultant economic burden of readmission. Additionally, we analyzed readmission for TC at 6 months. RESULTS We studied 5997 patients admitted with TC, of whom 1.2% experienced in-hospital mortality. Median age was 67 years, with 91.5% being female. Among survivors, 10.3% were readmitted within 1 month; 25% of the initial 1-month readmissions occurred within 4 days, 50% within 10 days, and 75% within 20 days from discharge. The most common etiologies for readmission were cardiac (26%), respiratory (16%), and gastrointestinal (11%) causes. Heart failure was the most common cardiac etiology. Significant predictors of increased 1-month readmission included systemic thromboembolic events, length of stay ≥3 days, and underlying psychoses. Obesity and private insurance predicted lower 1-month readmission. The annual national cost impact for index admission and 1-month readmissions was ≈$112 million. Recurrent TC was seen among 1.9% of patients readmitted within 6 months. CONCLUSIONS Though the overall rate of 1-month readmission following TC is low, associated economic burden from readmission is still significant. Patients are readmitted mostly for noncardiac causes. Readmission for another episode of TC within 6 months was uncommon.
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Affiliation(s)
- Mahek Shah
- Department of Cardiology, Lehigh Valley Hospital, Allentown, Pennsylvania
| | - Pradhum Ram
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania
| | - Kevin Bryan U Lo
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania
| | - Natee Sirinvaravong
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania
| | - Brijesh Patel
- Department of Cardiology, Lehigh Valley Hospital, Allentown, Pennsylvania
| | - Byomesh Tripathi
- Department of Internal Medicine, St. Luke's Roosevelt Hospital Center, New York, New York
| | - Shantanu Patil
- Department of Medicine, SSM Health St. Mary's Hospital, St. Louis, Missouri
| | - Vincent M Figueredo
- Department of Cardiology, Albert Einstein Medical Center, Philadelphia, Pennsylvania
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Bentata Y, El Maghraoui H, Benabdelhak M, Haddiya I. Management of hypercalcaemic crisis in adults: Current role of renal replacement therapy. Am J Emerg Med 2018; 36:1053-1056. [PMID: 29631925 DOI: 10.1016/j.ajem.2018.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/25/2018] [Accepted: 03/06/2018] [Indexed: 11/16/2022] Open
Abstract
Neoplasms and hematologic diseases are the predominant etiologies of hypercalcemic crisis in adults and the immediate treatment is mainly medical and symptomatic. The use of renal replacement therapy (RRT) is often necessary to correct the hypercalcemia, uremia and electrolyte disturbances related to Acute Kidney Injury (AKI). The aim of this work was to determine the etiologies and the place of RRT in treating patients with hypercalcaemic crisis. We conducted a retrospective study for 36months at the Nephrology Unit, University Hospital, Oujda, eastern of Morocco. We included all adult patients diagnosed with hypercalcemic crisis that was defined as corrected total serum calcium of >3.5mmol/l. RESULTS 12 patients were collected. All patients were female and 5 patients were elderly (≥65years). Three patients had a serum calcium value of >4mmol/l and the highest calcium value was 5.8mmol/l. Electrocardiographic abnormalities were observed in 8 cases. AKI was observed in 8 cases. Three patients had chronic kidney disease on hemodialysis. Neoplasm was noted in 9 cases. All patients received venous rehydration, glucocorticoids and biphosphonates. The use of RRT with low calcium dialysate was performed in 11 cases. Three patients died during the first 24h of hospitalization. CONCLUSION RRT must play its full role as first line treatment of hypercalcemia crisis. Improvements in hemodialysis techniques and the use of low calcium or calcium-free dialysates currently allows this therapeutic measure to be prescribed safely, and the benefit-risk balance is positive for the great benefit provided by dialysis.
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Affiliation(s)
- Yassamine Bentata
- Nephrology unit, University Hospital Mohammed VI, University Mohammed the First, Oujda, Morocco; Laboratory of Epidemiology, Clinical Research and Public Health, Medical School, University Mohammed The First, Oujda, Morocco.
| | - H El Maghraoui
- Nephrology unit, University Hospital Mohammed VI, University Mohammed the First, Oujda, Morocco
| | - M Benabdelhak
- Nephrology unit, University Hospital Mohammed VI, University Mohammed the First, Oujda, Morocco
| | - I Haddiya
- Nephrology unit, University Hospital Mohammed VI, University Mohammed the First, Oujda, Morocco
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Batouche DD, Benatta M, Okbani R, Benatta NF. [High blood pressure during the autonomic crises in children in intensive care unit: Etiologic circumstances and modality therapeutic]. Ann Cardiol Angeiol (Paris) 2017; 66:176-180. [PMID: 28684012 DOI: 10.1016/j.ancard.2017.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 06/01/2017] [Indexed: 06/07/2023]
Abstract
UNLABELLED The dysautonomic (DC) or neurovegetative crisis remains an imperfectly known entity; it associates in a paroxysmal manner a reaction of sympathetic hyperreactivity that can lead to the prognosis. Our objective is to specify the etiological circumstances (DC) and their modality of treatment in pediatric intensive care unit. MATERIALS-METHODS Descriptive study on files of children admitted in the intensive care unit of 2010-2015 who presented a DC acquired during their hospitalization. RESULTS In total, 41 patients included with an average age of 56.92 months presented DC. Among the etiological circumstances Guillain-Barré syndrome and head trauma are noted. Observed symptoms occur on average at one week of admission; they are related to the consequences of DC. The manifestations are polymorphic: a systolic hypertension is present in all cases with an average PAS of 141.24±13.48mmHg, an average PAD of 86.80±11.01mmHg, a vasomotor disorder, a hyperthermia are noted. Cerebral anoxia post cardiac arrest in 4 patients preceded the onset of DC. Apart from the etiologic treatment, 39 patients were intubated with mechanical ventilation, sedated with morphinomimetic and benzodiazepine±lioresal (baclofen). Treatment of hypertension resulted in the administration of a central antihypertensive. Evolution is good in addition to 5 deaths related to neurovegetative disorders. CONCLUSION DC is a poorly understood situation in pediatric intensive care unit, and the circumstances of the disease are variable. The diagnosis must be made with careful consideration because the prognosis may be fatal.
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Affiliation(s)
| | - M Benatta
- Faculté de médecine Oran, Oran, Algérie
| | - R Okbani
- Département de psychologie, université d'Oran, Oran, Algérie
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Contejean A, Lemiale V, Resche-Rigon M, Mokart D, Pène F, Kouatchet A, Mayaux J, Vincent F, Nyunga M, Bruneel F, Rabbat A, Perez P, Meert AP, Benoit D, Hamidfar R, Darmon M, Jourdain M, Renault A, Schlemmer B, Azoulay E. Increased mortality in hematological malignancy patients with acute respiratory failure from undetermined etiology: a Groupe de Recherche en Réanimation Respiratoire en Onco-Hématologique (Grrr-OH) study. Ann Intensive Care 2016; 6:102. [PMID: 27783381 PMCID: PMC5080277 DOI: 10.1186/s13613-016-0202-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 10/11/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Acute respiratory failure (ARF) is the most frequent complication in patients with hematological malignancies and is associated with high morbidity and mortality. ARF etiologies are numerous, and despite extensive diagnostic workflow, some patients remain with undetermined ARF etiology. METHODS This is a post-hoc study of a prospective multicenter cohort performed on 1011 critically ill hematological patients. Relationship between ARF etiology and hospital mortality was assessed using a multivariable regression model adjusting for confounders. RESULTS This study included 604 patients with ARF. All patients underwent noninvasive diagnostic tests, and a bronchoscopy and bronchoalveolar lavage (BAL) was performed in 155 (25.6%). Definite diagnoses were classified into four exclusive etiological categories: pneumonia (44.4%), non-infectious diagnoses (32.6%), opportunistic infection (10.1%) and undetermined (12.9%), with corresponding hospital mortality rates of 40, 35, 55 and 59%, respectively. Overall hospital mortality was 42%. By multivariable analysis, factors associated with hospital mortality were invasive pulmonary aspergillosis (OR 7.57 (95% CI 3.06-21.62); p < 0.005), use of invasive mechanical ventilation (OR 1.65 (95% CI 1.07-2.55); p = 0.02), a SOFA score >7 (OR 3.32 (95% CI 2.15-5.15); p < 0.005) and an undetermined ARF etiology (OR 2.92 (95% CI 1.71-5.07); p < 0.005). CONCLUSIONS In patients with hematological malignancies and ARF, up to 13% remain with undetermined ARF etiology despite comprehensive diagnostic workup. Undetermined ARF etiology is independently associated with hospital mortality. Studies to guide second-line diagnostic strategies are warranted. ClinicalTrials.Gov NCT01172132.
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Affiliation(s)
| | | | | | - Djamel Mokart
- Réanimation, Institut Paoli Calmettes, Marseille, France.,Medical Intensive Care Unit, Hôpital Saint-Louis, ECSTRA Team, Biostatistics and Clinical Epidemiology, UMR 1153 (Center of Epidemiology And Biostatistics Sorbonne Paris Cité, CRESS), INSERM, Université Paris Diderot Sorbonne, 1, Avenue Claude Vellefaux, 75010, Paris, France
| | - Frédéric Pène
- Réanimation médicale, Hôpital Cochin, APHP, Paris, France
| | - Achille Kouatchet
- Service de Reanimation Médicale et Médecine Hyperbare, CHU Angers, Angers, France
| | - Julien Mayaux
- Service de Pneumologie et Réanimation, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France
| | - François Vincent
- Réanimation polyvalente, Hôpital Avicenne, APHP, Bobigny, France
| | - Martine Nyunga
- Réanimation polyvalente, Hôpital V.Provo, Roubaix, France
| | - Fabrice Bruneel
- Réanimation polyvalente, Hôpital de Versailles, Le Chesnay, France
| | - Antoine Rabbat
- Réanimation médicale, Hôpital Cochin, APHP, Paris, France
| | - Pierre Perez
- Réanimation médicale, Hôpital Brabois, Nancy, France
| | - Anne-Pascale Meert
- Service des Soins Intensifs Medico-Chirurgicaux et Oncologie Thoracique, Institut Jules Bordet, Brussels, Belgium
| | | | | | - Michael Darmon
- Réanimation polyvalente, CHU de Saint-Etienne, Saint-Piest-en-Jarrez, France
| | | | - Anne Renault
- Réanimation et Urgences Médicales, CHU de la Cavale Blanche, Brest, France
| | | | - Elie Azoulay
- Réanimation médicale, Hôpital Saint Louis, APHP, Paris, France. .,Medical Intensive Care Unit, Hôpital Saint-Louis, ECSTRA Team, Biostatistics and Clinical Epidemiology, UMR 1153 (Center of Epidemiology And Biostatistics Sorbonne Paris Cité, CRESS), INSERM, Université Paris Diderot Sorbonne, 1, Avenue Claude Vellefaux, 75010, Paris, France.
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Bou Khalil R, Khoury E, Koussa S. Linking multiple pathogenic pathways in Alzheimer’s disease. World J Psychiatry 2016; 6:208-214. [PMID: 27354962 PMCID: PMC4919259 DOI: 10.5498/wjp.v6.i2.208] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/16/2016] [Accepted: 05/11/2016] [Indexed: 02/05/2023] Open
Abstract
Alzheimer’s disease (AD) is a chronic neurodegenerative disorder presenting as progressive cognitive decline with dementia that does not, to this day, benefit from any disease-modifying drug. Multiple etiologic pathways have been explored and demonstrate promising solutions. For example, iron ion chelators, such as deferoxamine, are a potential therapeutic solution around which future studies are being directed. Another promising domain is related to thrombin inhibitors. In this minireview, a common pathophysiological pathway is suggested for the pathogenesis of AD to prove that all these mechanisms converge onto the same cascade of neuroinflammatory events. This common pathway is initiated by the presence of vascular risk factors that induce brain tissue hypoxia, which leads to endothelial cell activation. However, the ensuing hypoxia stimulates the production and release of reactive oxygen species and pro-inflammatory proteins. Furthermore, the endothelial activation may become excessive and dysfunctional in predisposed individuals, leading to thrombin activation and iron ion decompartmentalization. The oxidative stress that results from these modifications in the neurovascular unit will eventually lead to neuronal and glial cell death, ultimately leading to the development of AD. Hence, future research in this field should focus on conducting trials with combinations of potentially efficient treatments, such as the combination of intranasal deferoxamine and direct thrombin inhibitors.
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Magagi IA, Adamou H, Habou O, Magagi A, Halidou M, Ganiou K. [Digestive surgical emergencies in Sub-Saharan Africa: a prospective study of a series of 622 patients at the National Hospital of Zinder, Niger]. Bull Soc Pathol Exot 2017; 110:191-7. [PMID: 27299912 DOI: 10.1007/s13149-016-0499-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 03/22/2016] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to describe the epidemiologic, therapeutic, and prognostic aspects of surgical acute abdomen at the National Hospital of Zinder (HNZ). This was a prospective study of patients undergoing digestive surgical emergencies in HNZ over 24 months (January 2013-December 2014). During the study period, 622 digestive surgical emergencies were operated. The mean age was 22.91 ± 18.14 years old, with a sex-ratio of 3:1. The average admission time was 64.31 ± 57.90 h. Abdominal pain was the main reason for admission in 61.90% (N = 385) of the cases, with or without fever throughout the course in 26.05% (N = 162) of the cases. The average time before surgery was 9.13 ± 5.97 h. Acute peritonitis accounted for 51.61% (N = 321) of cases, led by ileal perforation maybe from typhoid (N = 175). The acute intestinal obstruction and acute appendicitis accounted for 27.49% (N = 171) and 9.65% (N = 60) of the cases, respectively. Abdominal trauma had affected 53 patients (8.52%). The average length of hospital stay was 8.71 ± 5.29 days. Postoperative morbidity was 38.10% (N = 237). Septic complications (N = 187) were predominant. Overall lethality of 13.67% (N = 85), was associated with the delay of diagnosis and treatment (P < 0.001). The incidence and the high morbidity and lethality of digestive surgical emergencies in the Sub-Saharan context, could be avoided through prevention, early consultation, and adequate intra-hospital management.
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Noilhan C, Barigou M, Bieler L, Amar J, Chamontin B, Bouhanick B. Causes of secondary hypertension in the young population: A monocentric study. Ann Cardiol Angeiol (Paris) 2016; 65:159-164. [PMID: 27209493 DOI: 10.1016/j.ancard.2016.04.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 04/20/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To study the prevalence of different causes of hypertension in young adults referred to a hypertension center in the south west of France. METHODS We conducted a retrospective overview of patients younger than 40years old hospitalized consecutively in the Hypertension department of Toulouse University Hospital between 2012 and 2014. Clinical data about gender, age, anthropomorphic parameters and blood pressure measurement by 24h Ambulatory Blood Pressure Monitoring (ABPM) were recorded. Biological data concerned dosages of kalemia, renin and aldosterone in the supine or after 15min of seating. Recorded radiological examinations were renal artery ultrasound and abdominal CT scan. RESULTS One hundred and forty-eight detailed medical records were analyzed, 69 women and 79 men. Among the 69 women, the causes of secondary hypertension were primary aldosteronism (n=7), fibromuscular dysplasia (n=5) and renal disease (n=4). Oral contraceptives were involved in 13 women. In addition, essential hypertension concerned 40 women (58%). Among the 79 men, the causes of secondary hypertension were primary aldosteronism (n=10), fibromuscular dysplasia (n=3), left main renal artery entrapment by a diaphragmatic crura (n=2), renal disease (n=1), pheochromocytoma (n=3) and coarctation of the aorta (n=2). In addition, essential hypertension concerned 58 men (73%). CONCLUSIONS In our population, the prevalence of secondary hypertension is close to 33% (42% of females and 27% of males), with the following main causes: primary aldosteronism for 11.5%; fibromuscular dysplasia for 5.4%. Oral contraceptives were involved in the hypertension of 19% of the females.
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Affiliation(s)
- C Noilhan
- Hypertension department, Cardiovascular and metabolic center, Rangueil University Hospital, Toulouse, France
| | - M Barigou
- Hypertension department, Cardiovascular and metabolic center, Rangueil University Hospital, Toulouse, France.
| | - L Bieler
- Hypertension department, Cardiovascular and metabolic center, Rangueil University Hospital, Toulouse, France
| | - J Amar
- Hypertension department, Cardiovascular and metabolic center, Rangueil University Hospital, Toulouse, France
| | - B Chamontin
- Hypertension department, Cardiovascular and metabolic center, Rangueil University Hospital, Toulouse, France
| | - B Bouhanick
- Hypertension department, Cardiovascular and metabolic center, Rangueil University Hospital, Toulouse, France
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Abstract
OBJECTIVE Our aim was to examine the characteristics of delirium in the severely medically ill cancer population on the basis of sociodemographic and medical variables, delirium severity, and phenomenology, as well as severity of medical illness. METHOD All subjects in the database were recruited from psychiatric referrals at Memorial Sloan Kettering Cancer Center (MSKCC). Sociodemographic and medical variables, as well as the Karnofsky Performance Status (KPS) scale and Memorial Delirium Assessment Scale (MDAS) scores were recorded at baseline. Subsequently, these variables were analyzed with respect to the severity of the medical illness. RESULTS Out of 111 patients, 67 qualified as severely medically ill. KPS scores were 19.7 and 30.7 in less severe illness. There were no significant differences with respect to age, history of dementia, and MDAS scores. Although the severity of delirium did not differ, an increased frequency and severity of consciousness disturbance, disorientation, and inability to maintain and shift attention did exist. With respect to etiologies contributing to delirium, hypoxia and infection were commonly associated with severe illness. In contrast, corticosteroid administration was more often associated with less severe illness. There were no differences with respect to opiate administration, dehydration, and CNS disease, including brain metastasis. SIGNIFICANCE OF RESULTS Delirium in the severely medically ill cancer population has been characterized by an increased disturbance of consciousness, disorientation, and an inability to maintain and shift attention. However, the severity of illness did not predict severity of delirium. Furthermore, hypoxia and infection were etiologies more commonly associated with delirium in severe illness, whereas the administration of corticosteroids was associated with less severe illness.
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Affiliation(s)
- Soenke Boettger
- Department of Psychiatry and Psychotherapy,University Hospital Zurich,Zurich,Switzerland
| | - Josef Jenewein
- Department of Psychiatry and Psychotherapy,University Hospital Zurich,Zurich,Switzerland
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences,Memorial Sloan Kettering Cancer Center,New York,New York
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Chouchene I, Derouiche K, Ben Halim N, Merdassi A, Limaiem R, Abdelhak S, El Matri L. Retinal dystrophy and congenital glaucoma as major causes of vision loss in students attending two institutions for the visually disabled in Tunis city, Tunisia. J Fr Ophtalmol 2014; 37:695-701. [PMID: 25199482 DOI: 10.1016/j.jfo.2014.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 03/12/2014] [Accepted: 03/19/2014] [Indexed: 11/23/2022]
Abstract
PURPOSE To assess vision loss, identify affected anatomical sites, determine etiologies and potentially avoidable causes in students attending two institutions for the visually disabled in Tunis city. METHODS A visit for a complete ophthalmological examination was performed. All students attending these schools were recruited in our study. The World Health Organisation Programme for the Prevention of Blindness (WHO/PBL) examination record for children was used. Data was analysed by the SPSS version 17 statistical software. RESULTS A total of 172 students were recruited with mean age of 11.9±3.3 years (between 6 and 18 years). One hundred and thirty-seven (79.6%) were under 16 years. The sex-ratio was 1.17. Ninety students (52.3%) had low vision and eighty-two (47.7%) were blind. We reported retina (29%), whole globe (29%), globe appears normal (11%) and optic nerve (9.8%) as the common sites of ocular abnormalities. Retinal dystrophy (22.7%) and congenital glaucoma (22.7%) were the most reported ocular diseases. The main etiologies were hereditary (54.1%) and unknown (30.8%). Consanguinity was reported in 108 students (62.8%), and fifty-five students (32%) had a positive family history. Overall, 50.5% (87/172) of ocular diseases were potentially treatable or preventable. CONCLUSION Retinal dystrophy and congenital glaucoma were the most common eye diseases. Heredity was the main etiology, and consanguinity was high. To decrease their incidence, awareness of the family members of the risks of consanguinous marriage and appropriate therapy for congenital glaucoma/cataract may significantly improve the child's visual prognosis.
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Abstract
Thrombotic microangiopathy (TMA) is a serious complication of renal transplantation. It is a morphological expression of various etiological factors. In a renal allograft, TMA can occur de novo or be a recurrent disease. The aim of this study was to analyze the etiological factors and observe the changing trends of TMA with respect to emerging new etiological factors. We evaluated 131 graft biopsies over a period of 2½ years (2010-2012). All the renal biopsies were formalin fixed, paraffin embedded. Twenty serial sections were studied. Stains routinely used were Hematoxylin and Eosin, Periodic Acid Schiff, Massons Trichrome and Silver Methenamine stains. C4d by immunohistochemical method was done on all graft biopsies. Incidence of TMA in our series was 9.1%. Out of the 12 cases, five were associated with calcineurin inhibitor toxicity, three were diagnosed as acute antibody-mediated rejection, and two were recurrent haemolytic uremic syndrome. One patient developed haemolytic uremic syndrome on treatment with sirolimus and one patient was cytomegalovirus positive on treatment with ganciclovir, developed haemolytic uremic syndrome during treatment course. This study describes a spectrum of etiological factors for thrombotic mciroangiopathy ranging from common cause like calcineurin inhibitor toxicity to rare cause like ganciclovir induced TMA.
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Affiliation(s)
- S Radha
- Consultant, Department of Pathology, Aware Global Hospitals, Visakhapatnam, India
| | - Afroz Tameem
- Consultant, Department of Pathology, Aware Global Hospitals, Visakhapatnam, India
| | - G Sridhar
- Department of Nephrology, Aware Global Hospitals, Consultant, Visakhapatnam, India
| | - A Aiyangar
- Department of Nephrology, Aware Global Hospitals, Consultant, Visakhapatnam, India
| | - K G Rajaram
- Consultant, Department of Nephrologist, Hyderabad Kidney and Laparoscopic Centre, Visakhapatnam, India
| | - R Prasad
- Professor of Nephrology, Andhra Medical College and King George Hospital, Visakhapatnam, India
| | - K Kiran
- Consultant Nephrologist, Kamineni Hospitals, Hyderabad, India
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Nguefack S, Massi Gams D, Moifo B, Mah E, Chiabi A, Bogne JB, Mbonda PC, Tchokoteu PF, Mbonda E. [Clinical and etiological aspects of focal epilepsy in children at Yaoundé Gynaeco-obstetric Hospital (Cameroon)]. Mali Med 2014; 29:5-16. [PMID: 30049122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To describe the clinical and etiological aspects of child focal epilepsy at Yaoundé Gynaeco-Obstetric and Pediatric Hospital (YGOPH) in Cameroon. PATIENTS AND METHODS It was a cross-sectional descriptive study carried out in pediatric neurology and epileptology unit of YGOPH from October 1st 2011 to March 30th 2012. We included 218 patients aged 0-16 years with a diagnosis of focal epilepsy in whom an electroencephalogram (EEG) was performed. The studied variables were epidemiological, etiological factors, type of epilepsy, EEG abnormalities, abnormalities in brain CT-scan, and probable etiology. RESULTS The sex ratio was 1.34 M/1F. The mean age of patients was 8 ± 4 years. In 58.71% (128/218) the onset of crises was before the age of five and decreased gradually until adolescence. The EEG showed an epileptic focus in 161 patients (73.85%). The main foci were centro-temporal (19.9%), frontal (19.2%), temporal (14.9%) and fronto-temporal (14.9%). The CT-scan was abnormal in 58 (56.86%) of 102 patients, who performed head CT-scan, with as major abnormalities, brain atrophy and after-effects lesions. Etiological factors were found in 76.15 % of patients, it was mainly neonatal asphyxia (21%), family history of epilepsy (20.6%) and febrile seizures (19.7%). Focal epilepsies were of structural (51.4%), genetic (24.3%) or unknown causes. Neurological abnormalities associated were more frequently in focal epilepsies of structural causes. CONCLUSION The focal child epilepsies are mostly of structural causes and preferentially temporal and/or frontal in location. The main etiological factors are family history of epilepsy and neonatal asphyxia.
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Affiliation(s)
- S Nguefack
- Service de pédiatrie et des sous spécialités pédiatriques- Hôpital gynéco-obstétrique et pédiatrique de Yaoundé
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
| | - D Massi Gams
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
| | - B Moifo
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
- Service de radiologie-Hôpital gynéco-obstérique et pédiatrique de Yaoundé
| | - E Mah
- Service de pédiatrie et des sous spécialités pédiatriques- Hôpital gynéco-obstétrique et pédiatrique de Yaoundé
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
| | - A Chiabi
- Service de pédiatrie et des sous spécialités pédiatriques- Hôpital gynéco-obstétrique et pédiatrique de Yaoundé
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
| | - J B Bogne
- Service de pédiatrie et des sous spécialités pédiatriques- Hôpital gynéco-obstétrique et pédiatrique de Yaoundé
| | - P C Mbonda
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
| | - P F Tchokoteu
- Service de pédiatrie et des sous spécialités pédiatriques- Hôpital gynéco-obstétrique et pédiatrique de Yaoundé
| | - E Mbonda
- Service de pédiatrie et des sous spécialités pédiatriques- Hôpital gynéco-obstétrique et pédiatrique de Yaoundé
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
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Anegundi RT, Patil SB, M S, Havale R. Pediatric Dental Trauma:Wide Horizon of Ignored Etiological Factors. Int J Clin Pediatr Dent 2010; 4:101-4. [PMID: 27672246 PMCID: PMC5030493 DOI: 10.5005/jp-journals-10005-1090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 03/15/2011] [Indexed: 11/23/2022] Open
Abstract
Trauma of the oral and peroral structures are one of the most common and frequent complaints after dental caries with which a child is being referred to a dental clinic. As an emergency, we tend to treat the injuries without understanding or neglecting the cause of trauma. The different possible etiological factors are unnoticed, not revealed or not noted while taking the history of the patient. Sometimes negligence of the etiology by the dentist himself or the accompanying person could influence the prognosis and prevention. Thus, this paper is an effort towards exploring the common yet unnoticed etiological factors of pediatric dental trauma which we tend to knowingly ignore.
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Affiliation(s)
- Rajesh T Anegundi
- Professor and Head, Department of Pediatric Dentistry, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Shruthi B Patil
- Associate Professor, Department of Pediatric Dentistry, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Shubha M
- Postgraduate Student, Department of Pediatric Dentistry, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Raghavendra Havale
- Assistant Professor, Department of Pediatric Dentistry, AME's Dental College, Raichur, Karnataka, India
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